Treating Prostate Cancer: Jeff Metcalf's Story

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Prostate cancer is the most common cancer among men. In fact, 1 in 8 men will be diagnosed with prostate cancer during their lifetimes. Many patients receive a diagnosis of prostate cancer and immediately begin to imagine difficult and time-consuming radiation treatments, but Huntsman Cancer Institute is pioneering new technology to help these patients and offering them renewed hope for the future.

Jeff Metcalf is the perfect example. Jeff was diagnosed in 2004 when he thought he was in great health. He'd had a physical every year since he was 30, so he was surprised when he got a call from his doctor telling him his PSA was an 8. Says Jeff, "I had no idea what a PSA was. I thought, a public service announcement?"

Unfortunately, the news wasn't good. It was prostate cancer, and the doctor gave him two years to live. Jeff underwent radiation treatment in 2004 but decided to be treated at Huntsman Cancer Institute in 2005 when the cancer recurred.

He began working with Dr. Jonathan Tward, who has changed Jeff's prognosis from two years to live to having no evidence of cancer in his body years later. Jeff's health is closely monitored and will continue to be for many years.

Dr. Tward says that the past decade has brought dramatic improvement in prostate cancer treatment. These days, physicians like Dr. Tward use high-tech imaging to guide beams of radiation to tumors with pinpoint accuracy, even allowing for constant natural movements of organs within a patient's anatomy. The accuracy allows the radiation doses to be directed right at the tumor, which reduces the number of treatments necessary and keeps surrounding healthy tissue from being harmed.

"If you look at what we call our high-risk prostate cancer program here, we will be able to cure 80 to 90% of those persons, " says Dr. Tward, "but in the past, it was at the expense of their bladder or bowel. Now, when we set them up on our treatment machines for maybe only a five-treatment regimen, we can see right inside and within a fraction of a millimeter know exactly where their prostate is at all times."

The equipment used at Huntsman Cancer Institute destroys tumors with high energy x-rays that can kill the DNA in cancer cells. The complex machine eradicates prostate cancer without the invasive procedures and time away from family and work patients faced in the past. In fact, as few as five treatments may be all that is needed now compared to the once prescribednine weeks of daily radiation.

Another innovation in use at Huntsman Cancer Institute is a new hydro-gel that can be inserted between the prostate and the rectum. This gives doctors a big space buffer that substantially reduces the radiation dose to the bowel.

For patients like Jeff, this is welcome news.

"You know, 12 years ago, compared to what they are doing now, it seems almost barbaric. You'd flash the radiation, and now they can target it on specific areas."

Says Dr. Tward, "I think Jeff has a pretty much normal life expectancy. I am not going to give up on Jeff ever. I think he should plan to die an old man someday, surrounded by his great-grandchildren."

After his diagnosis and journey with cancer, Jeff decided there was a need to talk to other men about prostate cancer. He ended up writing a comedy about medicine called, "A Slight Discomfort." The play has toured all over the United States and four countries, creating a dialogue among men.

Says Jeff, "My dream ultimately would be to outlive my own play. To have some institution say, we have a cure for this thing and your play has no value anymore. But for now, I am going to keep staying above ground.

"The last four times I have been to Huntsman Cancer Institute, my PSA has been negligible, and I couldn't imagine saying that five years ago.

"When my diagnosis looked the grimmest," Jeff says, "I thought, I have to think about this as a chronic disease and not a death sentence, and that's made all the difference."

Huntsman Cancer Institute (HCI) is a National Cancer Institute (NCI)-Designated Comprehensive Cancer Center, which means it meets the highest standards for cancer research and receives support for its scientific endeavors. HCI is located on the campus of the University of Utah in Salt Lake City and is a part of the University of Utah Health Care system. HCI treats patients with all forms of cancer and operates several high-risk clinics that focus on melanoma and breast, colon, and pancreas cancers, among others. HCI also provides academic and clinical training for future physicians and researchers. For more information about HCI, please visit www.huntsmancancer.org.